Murmurs & Lung Sounds

Question 1

things to consider when grading murmurs “SCRIPT”

Most important 2

Answer 1

Site
Character
Radiation
Intensity
Pitch
Timing

Timing & severity

Question 2

• Grade I

Answer 2

Lowest intensity, not audible

Question 3

• Grade II

Answer 3

• soft, but heard in all positions

Question 4

• Grade III

Answer 4

Moderate

Question 5

• Grade IV

Answer 5

Moderate intensity, Thrill

Question 6

• Grade V

Answer 6

• barely place stethoscope on chest & hear Thrill

Question 7

• Grade VI

Answer 7

can hear a L/H/T w/stethoscope off pt

Question 8

T/F: A thrill associated with a murmur represents significant turbulence and is always pathologic

Answer 8

True. yikes

Question 9

T/F: For practical purposes, a diastolic murmur is never pathologic.

Answer 9

False. Diastolic murmurs are always pathologic

Question 10

-Popping open of air-fluid levels as airways dilate with inspiration

Answer 10

Lung crackles/rales

Question 11

-Pneumonia, atelectasis, pulmonary fibrosis, acute bronchitis, bronchiectasis, interstitial lung disease, pulmonary edema/CHF, COVID-19

Answer 11

Lung Crackles/Rales

Question 12

-Asthma, COPD, anaphylaxis, foreign object, smoking, allergies, bronchitis, epiglottitis, CHF, drugs (ie: ASA), pneumonia, respiratory tract infection, vocal cord dysfunction

Answer 12

Wheeze

Question 13

-May clear with coughing, gurgling or bubbling sounds usually during inhalation & exhalation

Answer 13

Rhonchi

Question 14

-COPD (often chronic bronchitis), bronchiectasis, cystic fibrosis, viral URI, secretions in airway

Answer 14

Rhonchi

Question 15

Pericardial friction rub

Answer 15

Pericarditis

Question 16

Systolic Murmurs (6)

Answer 16

-Aortic stenosis, Pulmonic stenosis, mitral regurgitation, tricuspid regurgitation, mitral valve prolapse, HCM

Question 17

Diastolic murmur (4)

Answer 17

Aortic regurgitation, pulmonic regurgitation, mitral stenosis, tricuspid stenosis

Question 18

Continuous murmur (1)

Answer 18

PDA

Question 19

-Usually on inhalation from narrowing in the airway (extrathoracic)

Answer 19

Stridor

Question 20

-Croup, laryngomalacia

Answer 20

Stridor

Question 21

The easy, not-scary murmur ID method (4 Steps)

Answer 21

Systolic or diastolic?

Where do you hear it best?

How loud is it, from I-VI?

(At IV and above, you can feel a lift/heave)

Order an echo, and it will tell you exactly the problem is 😊